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Ep 23 – Non-blanching rash in children

In her first podcast for GPnotebook, Dr Kate Chesterman discusses new evidence on the management of children with non-blanching rashes with Dr Edward Snelson. Dr Snelson is a Consultant Emergency Paediatrician at Sheffield Children’s Hospital and is the author of the blog GPpaedstips. Should we be treating every non-blanching rash as meningococcal disease, and if not, why not? What important differentials do we want to consider in children with a fever and a non-blanching rash? Can GPs safely decide which children require emergency treatment?


Key references and resources discussed in the episode:


Flowchart (courtesy of

The pragmatic approach to the child with non-blanching rash


Key take-home points from the episode:

  1. Invasive meningococcal disease is a rare but serious cause of non-blanching rashes in children.
  2. The presence of petechiae alone should no longer be viewed as a red flag.
  3. Careful clinical assessment for other signs of sepsis and meningococcal disease by an experienced clinician can reduce over investigation, treatment and admissions.

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